Breast Cancer, Reconstruction and Sex

This is a personal report about a consultation I had the other day with a plastic surgeon about fat grafting as a reconstruction procedure. The back-story is that I was diagnosed with breast cancer 25 years ago and had a partial mastectomy, axillary lymph node removal and radiation for my treatment. My left breast looks very much like the right breast, it’s just much smaller. 25 years ago I wasn’t offered reconstruction, nor did it occur to me to explore that possibility. My solution has been to wear a small soft prosthetic device (a little “falsie”) in my bra to push up the smaller breast and help my clothing to drape more evenly, and my cleavage to look even. This solution has been fine for all these years.

Recently while planning for a keynote presentation for a plastic surgery event, one of the plastic surgeons mentioned fat grafting, saying that it’s a great and simple procedure. He went on to say that the fat tissue can even help to repair some of the damage to radiated tissue and to scar tissue.

Hmmm, I thought, what if there is an easy and low risk way to build up my smaller breast with my own fat tissue, and maybe reducing my tummy a bit in the bargain? I decided to research this to see if it’s a possibility for me.

Fast forward to the consult with a young and obviously well-informed local plastic surgeon. He looked at my breast and told me something lovely, “Wow, your left breast looks just like your right breast, just smaller. There is no dimpling, indentation or any other obvious deformity.” I looked at my breast and realized that he was seeing my beauty as I see it, too. That felt good.

As he described the fat grafting procedure, I realized that it’s neither simple nor risk-free. He said it’s best for filling in indentations and smoothing out dimpling. In the situation of breast enhancement it’s a multi-step process that involves liposuction to extract the fat tissue; then layering it in the bottom of the breast and waiting to see how much of the tissue survives and “takes”. This would be a 2 or 3-time event, with general anesthesia each time, a risk of infection and no certainty that the grafts would be successful. He also said that the radiated skin doesn’t have the same pliability or flexibility as unradiated skin.

His expert opinion was that the best option would be to reduce the larger right breast to make it the same size as my left breast.

Red flag, big red flag for me! And here’s why ~ I have full sensation in my right breast and derive a great deal of sexual pleasure from these sensations. My breast is a large part of my intimate sexual play and helps greatly with my arousal. My left breast has very little sensation. I’m not willing to lose what I have in my right breast.

When I told the doctor this, he blushed and said he doesn’t usually consider the function of the breasts. That was a very telling remark. I went on to tell him a bit about my work and he said he’d share that with his patients, most of whom are women with breast cancer.

The bottom line? Ask questions. Trust what you know. Enjoy the pleasure zones in your body. Love who you are and what you have. And talk to me if you want other help with your intimate and sexual life. I believe that everyone on the cancer journey can have a wonderful intimate and sexual life!

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